Collection And Transport Of Urine For Culture

Urine specimens can easily become contaminated with periurethral, skin, perianal and vaginal flora. This contamination can be reduced to acceptable levels, if proper technique of urine collection is followed. The methods of collection differ according to the patient’s age, gender, clinical condition and history of catheterization. The common techniques of urine specimen collection are discussed below.

General Instructions:

Preferably, an early morning samples should be submitted for culture. Urine that has remained in the bladder for at least 4 hours has decreased chances of false negative results.

The sample should be processed within 2 hours after collection. If that is not possible then it should be refrigerated both during storage and transport, and processed within 24 hours. If refrigeration is not possible and delay is expected, at least 3 ml of sample should be collected in a container with preservatives (boric acid-glycerol or boric acid-Na formate).

The submitted sample should be appropriately labeled with name, age, gender of the patient and mode and time of sample collection.

Fungal cultures are included in the routine urine culture. For anaerobic culture, the sample should be a suprapubic aspirate submitted in a syringe.

Midstream urine by clean catch method
This is the commonest technique used in adults and children (toilet trained). The patient should be conscious, able to pass urine, not catheterized and a female patient should not be menstruating.

Separate the labia and cleanse the urethral meatus twice with sterile sponges soaked in plain soap and water from front to back and then rinse with sterile water or saline sponges twice. The same should be done for uncircumcised males after retracting the foreskin. No preparation is necessary for circumcised males.

After discarding the first 10 ml, collect at least 5-10 ml of voided urine in a sterile leak-proof container by moving into the stream of urine without halting or restarting the stream. Screw on the top of the container after making sure that there is no leakage.

Catheterized urine

Indwelling catheters:

Clamp the catheter till the patient senses the urge to urinate or the bladder becomes palpable. Clean the catheter port with 70% alcohol and collect 10 ml urine using a needle and syringe. Remove the clamp.

Straight catheter (in and out):

This technique is used by physician or trained health professional to collect the specimen from infants, or patients with neurogenic bladders. Urine is obtained directly from the bladder after cleansing the meatus with plain soap and water (as previously mentioned). Discard the first 15-30 ml and submit the next flow for culture.

Ileal conduit
Remove external device, cleanse the stoma with 70% alcohol, then iodine and then remove iodine with alcohol. Insert catheter tip into cleansed stoma to a depth beyond the fascial level and collect urine.

Suprapubic Aspiration
This is the preferred method of urine collection from infants and where interpretation of voided urine culture is difficult or anaerobic bacteria are suspected as cause of UTI. However this technique should be performed by physician or trained health professionals.

Bladder should be full and palpable. Shave and disinfect the skin over the bladder.

Make a small wound through the epidermis above the symphysis pubis and aspirate using a needle and syringe. Submit specimen in syringe or carefully sealed sterile container.

PLOS, in collaboration with GARDP, is delighted to announce the launch of the Antimicrobial Resistance (AMR) Channel during the World Health Assembly, Geneva. This new channel offers the AMR research ...

Healthcare-associated infections claim thousands of lives and cost the healthcare system billions of dollars annually. While the proper cleaning and disinfection of the physical environment is conside...

The recent rate of emergence of pathogenic fungi that are resistant to the limited number of commonly used antifungal agents is unprecedented. The azoles, for example, are used not only for human and ...

According to a recent @CDCgov report, the percentage of bacterial infections caused by Enterobacteriaceae nonsusceptible to extended-spectrum cephalosporins (ESBL phenotype) decreased 2% a year between 2006 and 2015. Learn more: https://t.co/uLABimgGpW